CH. 7 mood disorders (depression)

types of depression disorders

major depression, persistent depressive disorder, and premenstrual dysphoric disorder

types of mania disorders

bipolar I, bipolar II, annd cyclothymia

commonality of unipolar depression

20% of all adults experience unipolar depression at some time in their lives with the average onset being 19yo and with women being the majority at 26% and men being 12%

unipolar depression

a depressive episode without any history of manic or hypomanic episodes (depression that is not bipolar)

depression affects

emotions, motivations, physical functioning, behaviors, and cognitions (all parts of life)DS

DSM symptoms for major depression

1. depressed mood and/or decrease in enjoyment or interest (two week minimum)

2. weight/appetite change, daily insomnia/hypersomnia, daily agitation/ decrease in motor activity, worthlessness/guilt, reduction in concentration/decisiveness (3 or 4)

DSM symptoms for persistent depressive disorder

1. experiences the symptoms of major or mild depression for at least 2 years

2. symptoms not absent for more than 2 months at a time

3. no history of mania/hypomania (personality style depression)

reactive (exogenous) depression

stressful events may trigger episode (80% of severe episodes occur after a significant event like a breakup or family death)

endogenous depression

no triggered event takes place that triggers the episode (20% of cases of major depression)

biological model of depression

genetic factors, biochemical factors, brain circuits, and immune system

biochemical factors (biological model of depression)

low activity of serotonin and norepinephrine

brain circuits (biological model of depression)

irregular activity in various brain locations like the prefrontal cortex, hippocampus, amygdala, and subgenual cingulate

immune system (biological model of depression)

dysregulation of the immune system occurs under intense stress

biological treatments for depression

antidepressant drugs and brain stimulation

antidepressant drugs (biological treatments for depression)

monoamine oxidase inhibitors, tricyclic antidepressants, second gen SSRI/SNRI, ketamine based drugs (all increase serotonin and norepinephrine)

brain stimulation (biological treatments for depression)

directly or indirectly stimulate certain areas of the brain through ECT, vagus nerve stimulation, transcranical magnetic stimulation, and deep brain stimulation

*MAO inhibitors (biological treatments for depression)

increases activity level of neurotransmitters serotonin and norepinephrine by preventing their degradation in the synapse (cons: cant be taken with aged food and over the counter meds)

*tricyclic antidepressants (biological treatments for depression)

prevents neurotransmitter reuptake of key neurons (cons: tiredness and weight gain)

**second generation antidepressants (biological treatments for depression)

SSRI (selective serotonin reuptake inhibitors): increase serotonin activity only

SNRI (selective norepinephrine reuptake inhibitors): increase norepinephrine activity only

serotonn-norepinephrine reuptake inhibitors: increase both serotonin and norepinephrine activity

ketamine-based antidepressants (biological treatments for depression)

increase activity of glutamate, may aid in new neural pathway development, alleviates depression quickly, used for those unresponsive to other drugs or who are suicidal (short term impact)

*electroconvulsive therapy (ECT) (biological treatments for depression)

electrical shock is delivered to the brain to produce a convulsion (seizure) which sets off many neurotransmitters quickly to flood the brain and reset mood, used after medication/talk therapy (cons: memory loss)

vagus nerve stimulation (biological treatments for depression)

an implanted pulse generator sends electrical signals to the vagus nerve which delivers signals to the brain

psychodynamic model of depression

real or imagined (symbolic) loss

cognitive-behavioral models of depression

depression results from problematic behaviors and dysfunctional thinking (behavioral dimension, negative thinking, complex cognitive and behavioral factor interplay)

behavioral dimension (cognitive-behavioral model of depression)

number of life rewards related to presence or absence of depression, large reduction of positive life rewards may increase fewer positive behaviors, and loss of social rewards are important in downward depression spiral

negative thinking (cognitive-behavioral model of depression)

unipolar depression is produced by a combination of maladaptive attitudes, cognitive triad (negative view of experiences, oneself, the future), errors in thinking, and automatic thoughts

learned helplessness (cognitive-behavioral interplay model of depression)

when people don’t have control over their lives they eventually stop trying to escape that bad situation

cognitive-behavioral treatments for depression

behavioral activation, becks cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT)

behavioral activation (cognitive-behavioral treatments for depression)

reintroduce pleasurable activities, consistently reward nondepressive behaviors and withhold rewards for depressive ones, improve social skills

becks cognitive-behavioral therapy CBT (cognitive-behavioral treatments for depression)

1. increasing activities and elevating mood

2. challenging automatic thinking

3. identifying negative thinking and biases

4. changing primary attitudes

acceptance and commitment therapy ACT (cognitive-behavioral treatments for depression)

acknowledging that bad things happen and they those things are not a reflection of yourself

sociocultural model of depression

depression is influenced by social context and often triggered by outside stressors (family-social perspective and multicultural perspective)

interpersonal psychotherapy IPT (family-social treatments)

interpersonal loss, role disputes, role transitions, and deficits

multicultural perspective (sociocultural model of depression)

depression is found worldwide and the precise picture of depression varies slightly (more eastern countries report more physical symptoms of depression than cognitive symptoms)

gender and depression (multicultural perspective of depression)

across cultures women are twice as likely as men to receive a diagnosis for unipolar depression and have it appear much younger and last much longer (reasons: detection, hormone changes, life stress, body dissatisfaction, lack of control, rumination)

the developmental psychopathology perspective of depression

unipolar depression is caused by a combination of factors:

1. genetically inherited biological predisposition

2. influenced by significant early life trauma

3. magnitude and timing of negative factors

4. resiliency linked to moderate and manageable adversities throughout childhood

comparing depressive and bipolar disorders

depressive disorders are more prevalent and onset much earlier